Alternative uses of dermoscopy in general dermatology
Abstract
Over the last few years, dermoscopy has been shown to be an effective diagnostic tool in assisting the noninvasive diagnosis not only of skin tumors but also of various general dermatological disorders. The use of dermoscopy has offered a new morphological dimension supporting the diagnosis and clinical follow-up of several dermatological conditions. Within the last years, dermoscopy is gaining ground in general dermatology as well. Among the large spectrum of skin infections, specific dermoscopic patterns have been described for common skin infections such as viral warts, molluscum contagiosum, scabies, and pediculosis, as well as for tinea nigra, tungiasis, and cutaneous larva migrans. Also, common skin disorders such as psoriasis, pityriasis rosea or lichen planus show characteristic dermoscopic patterns. The aim of this article is to provide an overview of the use of dermoscopy in general dermatology by analyzing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical characteristics.
References
Argenziano G, Soyer HP, Chimenti S, Talamini R, Corona R, et al. Dermoscopy of pigmented skin lesions: Results of a consensus meeting via the Internet. J Am Acad Dermatol 2003; 48(5): 679–693. doi: 10.1067/mjd.2003.281.
Braun RP, Rabinovitz HS, Oliviero M, Kopf AW, Saurat JH. Dermoscopy of pigmented skin lesions. J Am Acad Dermatol 2005; 52(1): 109–121. doi: 10.1016/j.jaad. 2001.11.001.
Arrazola P, Mullani NA, Abramovits W. DermLite II: An innovative portable instrument for dermoscopy without the need of immersion fluids. Skinmed 2005; 4(2): 78–83. doi: 10.1111/j.1540-9740.2005.04363.x.
Hausermann P, Widmer A, Itin P. Dermatoscope as vector for transmissible diseases — No apparent risk of nosocomial infections in outpatients. Dermatology 2006; 212(1): 27–30. doi: 10.1159/000089018.
Kelly SC, Purcell SM. Prevention of nosocomial infection during dermoscopy? Dermatol Surg 2006; 32(4): 552–555. doi: 10.1111/j.1524-4725.2006.32112.x.
Zalaudek I, Argenziano G, Di Stefani A, Ferrara G, Marghoob AA, et al. Dermoscopy in general dermatology. Dermatology 2006; 212(1): 7–18. doi: 10.1159/00008-9015.
Micali G, Lacarrubba F, Musumeci ML, Massimino D, Nasca MR. Cutaneous vascular patterns in psoriasis. Int J Dermatol 2010; 49(3): 249–256. doi: 10.1111/j.1365- 4632.2009.04287.x.
Lallas A, Kyrgidis A, Tzellos TG, Apalla Z, Karakyriou E, et al. Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea. Br J Dermatol 2012; 166(6): 1198–1205. doi: 10.1111/ j.1365-2133.2012.10868.x.
Vázquez-López F, Zaballos P, Fueyo-Casado A, Sánchez-Martín. A dermoscopy subpattern of plaque type psoriasis: Red globular rings. Arch Dermatol 2007; 143(12): 1612. doi: 10.1001/archderm.143.12.1612.
Micali G, Lacarrubba F, Massimino D, Schwarz RA. Dermoscopy: Alternative uses in daily clinical practice. J Am Acad Dermatol 2011; 64(6): 1135–1146. doi: 10.1016/j.jaad.2010.03.010.
Pan Y, Chamberlain AJ, Bailey M, Chong AH, Haskett M, et al. Dermoscopy aids in the diagnosis of the solitary red scaly patch or plaque-features distinguishing superficial basal cell carcinoma, intraepidermal carcinoma, and psoriasis. J Am Acad Dermatol 2008; 59(2): 268–274. doi: 10.1016/j.jaad.2008.05.013.
Zalaudek I, Giacomel J, Schmid K, Bondino S, Rosendahl C, et al. Dermoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: A progression model. J Am Acad Dermatol 2012; 66(4): 589–597. doi: 10.1016/j.jaad.2011.02.011.
Giacomel J, Zalaudek I. Dermoscopy of superficial basal cell carcinoma. Dermatol Surg 2005; 31(12): 1710– 1713. doi: 10.2310/6350.2005.31314.
Zalaudek I, Argenziano G. Dermoscopy subpatterns of inflammatory skin disorders. Arch Dermatol 2006; 142(6): 808. doi: 10.1001/archderm.142.6.808.
Vázquez-López F, Vidal AM, Zalaudek I. Dermoscopic subpatterns of ashy dermatosis related to lichen planus. Arch Dermatol 2010; 146(1): 110. doi: 10.1001/archdermatol.2009.300.
Vázquez-López F, Alvarez-Cuesta C, Hidalgo-García Y, Pérez-Oliva N. The handheld dermatoscope improves the recognition of Wickham striae and capillaries in Lichen planus lesions. Arch Dermatol 2001; 137(10): 1376.
Vázquez-López F, Gómez-Díez S, Sánchez J, Pérez-Oliva N. Dermoscopy of active lichen planus. Arch Dermatol 2007; 143(8): 1092. doi: 10.1001/archderm.143.8.1092.
Vázquez-López F, Manjón-Haces JA, Maldonado-Seral C, Raya-Aguado C, Pérez-Oliva N, et al. Dermoscopic features of plaque psoriasis and lichen planus: New observations. Dermatology 2003; 207(2): 151–156. doi: 10.1159/ 000071785.
Vazquez-Lopez F, Palacios-Garcia L, Gomez-Diez S, Argenziano G. Dermoscopy for discriminating between lichenoid sarcoidosis and lichen planus. Arch Dermatol 2011; 147(9): 1130. doi: 10.1001/archdermatol.2011.278.
Vázquez-López F, Maldonado-Seral C, López-Escobar M, Pérez-Oliva N. Dermoscopy of pigmented lichen planus lesions. Clin Exp Dermatol 2003; 28(5): 554–555. doi: 10.1046/j.1365-2230.2003.01302.x.
Chuh AAT. Collarette scaling in pityriasis rosea demonstrated by digital epiluminescence dermoscopy. Australas J Dermatol 2001; 42(4): 288–290. doi: 10.1046/j.14400960.2001.00538.x.
Lallas A, Argenziano G, Apalla Z, Gourhant JY, Zaballos P, et al. Dermoscopic patterns of common facial inflammatory skin diseases. J Eur Acad Dermatol Venereol 2014; 28(5): 609–614. doi: 10.1111/jdv.12146.
Errichetti E, Stinco G. Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema. J Dermatol 2016; 43(4): 423–425. doi: 10.1111/13468138.13142.
Errichetti E, Stinco G. The practical usefulness of dermoscopy in general dermatology. G Ital Dermatol Venereol 2015; 150(5): 533–546.
Navarini AA, Feldmeyer L, Tőndury B, Fritsche P, Kamarashev J, et al. The yellow clod sign. Arch Dermatol 2011; 147(11): 1350. doi: 10.1001/archedermatol.2011. 297.
Errichetti E, Piccirillo A, Stinco G. Dermoscopy as an auxiliary tool in the differentiation of the main types of erythroderma due to dermatological disorders. Int J Dermatol 2016; 55(12): e616–e618. doi: 10.1111/ijd.13322.
Lallas A, Apalla Z, Lefaki I, Tzellos T, Karatolias A, et al. Dermoscopy of early stage mycosis fungoides. J Eur Acad Dermatol Venereol 2013; 27(5): 617–621. doi: 10.1111/j.1468-3083.2012.04499.x.
Vázquez-López F, Marghoob AA. Dermoscopic assessment of long-term topical therapies with potent steroids in chronic psoriasis. J Am Acad Dermatol 2004; 51(5): 811–813. doi: 10.1016/j.jaad.2004.05.020.
Stinco G, Lautieri S, Valent F, Patrone P. Cutaneous vascular alterations in psoriatic patients treated with cyclosporine. Acta Derm Venereol 2007; 87(2): 152–154. doi: 10.2340/00015555-0216.
Stinco G, Buligan C, Maione V, Valent F, Patrone P. Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy. Clin Exp Dermatol 2013; 38(6): 633–637. doi: 10.1111/ced.12036.
Vázquez-López F, Kreusch J, Marghoob AA. Dermoscopic semiology: Further insights into vascular features by screening a large spectrum of nontumoral skin lesions. Br J Dermatol 2004; 150(2): 226–231. doi: 10.1111/j.1365-2133.2004.05753.x.
Teoli M, Di Stefani A, Botti E, Mio G, Chimenti S. Dermoscopy for treatment monitoring of viral warts. Dermatology 2006; 212: 318.
Bristow IR, Bowling J. Dermoscopy as a technique for the early identification of foot melanoma. J Foot Ankle Res 2009; 2: 14. doi: 10.1186/1757-1146-2-14.
Zalaudek I, Giacomel J, Cabo H, Di Stefani A, Ferrara G, et al. Entodermoscopy: A new tool for diagnosing skin infections and infestations. Dermatology 2008; 16(1): 14–23. doi: 10.1159/000109353.
Watanabe T, Yoshida Y, Yamamoto O. Differential diagnosis of pearly penile papules and penile condyloma acuminatum by dermoscopy. Eur J Dermatol 2010; 20(3): 414–415. doi: 10.1684/ejd.2010.0944.
Dong H, Shu D, Campbell TM, Frühauf J, Soyer P, et al. Dermoscopy of genital warts. J Am Acad Dermatol 2011; 64(5): 859–864. doi: 10.1016/j.jaad.2010.03.028.
Veasev JV, de Souza Framil VM, Nadal SR, Marta AC, Lellis RF. Genital warts: Comparing clinical findings to dermatoscopic aspects, in vivo reflectance confocal features and histopathologic exam. An Bras Dermatol 2014; 89(1): 137–140. doi: 10.1590/abd1806-4841.20141917.
Morales A, Puig S, Malvehy J, Zaballos P. Dermoscopy of molluscum contagiosum. Arch Dermatol 2005; 141(12): 1644. doi: 10.1001/archderm.141.12.1644.
Ianhez M, Cestari SdaCP, Enokihara MY, Seize MBdPM. Dermoscopic patterns of molluscum contagiosum: A study of 211 lesions confirmed by histopathology. An Bras Dermatol 2011; 86(1): 74–79. doi: 10.1590/S0365- 05962011000100009.
Haliasos EC, Kerner M, Jaimes-Lopez N, Rudnicka L, Zalaudek I, et al. Dermoscopy for the pediatric dermatologist part I: Dermoscopy of pediatric infectious and inflammatory skin lesions and hair disorders. Pediatr Dermatol 2013; 30(2): 163–171. doi: 10.1111/pde.12097.
Zaballos P, Ara M, Puig S, Malvehy J. Dermoscopy of molluscum contagiosum: A useful tool for clinical diagnosis in adulthood. J Eur Acad Dermatol Venereol 2006; 20(4): 482–483. doi: 10.1111/j.1468-3083.2006.01480.x.
Smith SB, Beals SL, Elston DM, Meffert JJ. Dermoscopy in the diagnosis of tinea nigra plantaris. Cutis 2001; 68(6): 377–380.
Piliouras P, Alison S, Rosendahl C, Buettner PG, Weedon D. Dermoscopy improves diagnosis of tinea nigra: A study of 50 cases. Australas J Dermatol 2011; 52(3): 191–194. doi: 10.1111/j.1440-0960.2011.00790.x.
Zhou H, Tang XH, De Han J, Chen MK. Dermoscopy as an ancillary tool for the diagnosis of pityriasis versicolor. J Am Acad Dermatol 2015; 73(6): e205–e206. doi: 10.1016/j.jaad.2015.08.058.
Neynaber S, Wolff H. Diagnosis of scabies with dermoscopy. CMAJ 2008; 178(12): 1540–1541. doi: 10.1503/cmaj.061753.
Dupuy A, Dehen L, Bourrat E, Lacroix C, Benderdouche M, et al. Accuracy of standard dermoscopy for diagnosing scabies. J Am Acad Dermatol 2007; 56(1): 53–62. doi: 10.1016/j.jaad.2006.07.025.
Argenziano G, Fabbrocini G, Delfino M. Epiluminescence microscopy: A new approach to in vivo detection of Sar-coptes scabiei. Arch Dermatol 1997; 133(6): 751–753. doi: 10.1001/archderm.1997.03890420091011.
Lacarrubba F, D'Amico V, Nasca MR, Dinotta F, Micali G. Use of dermatoscopy and videodermatoscopy in therapeutic follow-up: A review. Int J Dermatol 2010; 49(8): 866–873. doi: 10.1111/j.1365-4632.2010.04581.x.
Suh KS, Han SH, Lee KH, Park JB, Jung SM, et al. Mites and burrows are frequently found in nodular scabies by dermoscopy and histopathology. J Am Acad Dermatol 2014; 71(5): 1022–1023. doi: 10.1016/j.jaad.2014.06.028.
Chouela E, Abeldaño A, Pellerano G, Hernández MI. Diagnosis and treatment of scabies: A practical guide. Am J Clin Dermatol 2002; 3(1): 9–18. doi: 10.2165/ 00128071-200203010-00002.
Hamm H, Beiteke U, Hőger PH, Seitz CS, Thaci D, et al. Treatment of scabies with 5% permethrin cream: Results of a German multicenter study. J Dtsch Dermatol Ges 2006; 4(5): 407–413. doi: 10.1111/j.1610-0387.2006.05941.x.
Di Stefani A, Hofmann-Wellenhof R, Zalaudek I. Der-moscopy for diagnosis and treatment of pediculosis capitis. J Am Acad Dermatol 2006; 54(5): 909–911. doi: 10.1016/j.jaad.2005.11.1083.
Bakos RM, Bakos L. Dermoscopy for diagnosis of pediculosis capitis. J Am Acad Dermatol 2007; 57(4): 727–728. doi: 10.1016/j.jaad.2006.11.011.
Criado PR, Landman G, dos Reis VMS, Belda W Jr. Tungiasis under dermoscopy: In vivo and ex vivo exami-nation of the cutaneous infestation due to Tunga penetrans. An Bras Dermatol 2013; 88(4): 649–651. doi: 10.1590/ abd1806-4841.20132071.
Bauer J, Forschner A, Garbe C, Rőcken M. Dermoscopy of tungiasis. Arch Dermatol 2004; 140(6): 761–763. doi: 10.1001/archderm.140.6.761.
Di Stefani A, Rudolph CM, Hofmann-Wellenhof R, Mül-legger RR. An additional dermoscopic feature of tungiasis. Arch Dermatol 2005; 141(8): 1045–1046. doi: 10.1001/archderm.141.8.1045.
Bauer J, Forschner A, Garbe C, Rőcken M. Variability of dermoscopic features of tungiasis. Arch Dermatol 2005; 141(5): 643–644. doi: 10.1001/archderm.141.5.643.
Bakos RM, Bakos L. ‘Whitish chains’: A remarkable in vivo dermoscopic finding of tungiasis. B J Dermatol 2008; 159(4): 991–992. doi: 10.1111/j.1365-2133.2008.08782.x.
Veraldi S, Schianchi R, Carrera C. Epiluminescence microscopy in cutaneous larva migrans. Acta Derm Venereol 2000; 80(3): 233.
Llambrich A, Zamballos P, Terrasa F, Torne I, Puig S, et al. Dermoscopy of cutaneous leishmaniasis. Br J Dermatol 2009; 160(4): 756–761. doi: 10.1111/j.1365-2133. 2008.08986.x.
Buljan M, Zalaudek I, Massone C, Hofmann-Wellenhof R, Fink-Puches R, et al. Dermoscopy and reflectance con-focal microscopy in cutaneous leishmaniasis on the face. Australas J Dermatol 2016; 57(4): 316–318. doi: 10.1111/ ajd.12404.
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